Renal replacement therapy in pediatric with acute renal failure
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2011-03-08
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Medical Journal of Srisaket Surin Buriram
Abstract
Background : Acute renal failure (ARF) in pediatric patients had high mortality rate(50%) and usually unrecognized in northeastern of Thailand.Objective : This study aimed to review the etiology and clinical outcome of ARFin Sappasitthiprasong hospital.Study Design : Descriptive retrospective study.Population : Pediatric patients who underwent renal replacement therapy (RRT) forARF at Sappasitthiprasong hospital, Ubonratchatani province of Thailand.From June 2005 to May 2009 were enrolled. Definition and classificationof ARF were correlated to K/DOQI 2003 guideline and modified RIFLEcriteria 2007.Results : Among 28 RRT-pediatric patients, 50% were male. Mean age of 10.6+-3.1 years (range 4-14 years). Most common clinical presentation and signs were volume overload and hypertension. Thirty two percent were secondary renal disease (APSGN 6, SLE 3), while 28.5% were tropical disease (Leptospirosis 3, Dengue shock syndrome 2, Wasp sting 2, Snake bite 1), 10.7% were primary renal disease (Ig A nephropathy 2, Nephrotic syndrome 1), and 7.1% due to Obstructive uropathy (Bilateral renalcalculi 1, bilateral ureteric calculi 1). Hemodialysis were prefered in 26 patient and shift to CAPD 6 patients, Acute PD were initially performed in 2 patients but 1 patient had catheter malfunction then shift to hemodialysis. Nearly half of patients (46.4%) had full recovery, 35.7% required long term RRT (CAPD 5, Hemodialyis 3, Kidney transplantation 2). Mortality rate was 17.9%. Conclusion : Secondary renal disease were the most common cause of ARF in this study. Half had fully recovery. Multiorgan failure which need ventilator support was associated with high mortality.
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Medical Journal of Srisaket Surin Buriram; Vol. 25 No. 1 January - April 2010; 43 - 55